Individual
DR. NICHOLAS RUDOLPH MATACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
421 E 4TH ST, DULUTH, MN 55805-1935
(218) 727-1448
Mailing address
1415 MISSISSIPPI AVE, DULUTH, MN 55811
(218) 310-5902
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D13811
MN
Other
Enumeration date
01/12/2011
Last updated
12/20/2017
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